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Overview
Exercise can help most people stay healthy and feel their best. Exercise can reduce stress, lower blood pressure and cholesterol, improve sleep, promote a healthy weight, and help prevent the development of heart disease and diabetes. For people with SMA, exercise has been a topic of debate as to whether the risks of muscle damage outweigh the possible benefits of preventing muscle wasting, improving mobility, strengthening lung capacity, and improving mood. Though there has been little research into exercise and SMA, some recent studies, however, have hinted towards modest benefits to supervised exercise in SMA patients.1,2

Many types of supervised gentle exercise, including physical therapy and practicing daily tasks may provide benefits to people with SMA.3

What does it involve?
Check with your doctor before beginning a new exercise regimen. Consult with a physical therapist or occupational therapist to develop a customized exercise plan that will be safe and effective for your or your child’s needs. There may be stretches and physical activities appropriate for you or your child.

It is important to choose a type of physical activity you or your child will enjoy and can regularly do. Some exercises which may be appropriate for people with SMA include water-based activities, stretching, or light resistance training. In general, exercise should be somewhat challenging, but never a struggle. It is also particularly important that people with SMA do not overexert their muscles, as damage to muscle may present the risk of speeding muscle atrophy.3

Whatever physical activity you choose, follow these general guidelines. Eat at least an hour and a half before exercising to avoid low blood sugar. Always begin the exercise session with a gradual warm-up and take the time to cool down afterward. Warming up and cooling down will help prevent injuries and sore muscles. Stay hydrated before, during, and after exercise with plenty of cool liquids, choosing beverages without caffeine.

It is important not to become discouraged early on when beginning a regimen of physical activity. At first, try to exercise for five or 10 minutes each day or as your physical therapist or doctor advises. As you become accustomed to the activity, with supervision you may be able to exercise for longer periods every day. Focus on finding ways of staying active that are safe, enjoyable and easy to do regularly. If new or worsening pain occurs, adjust your activity program to keep it safe and rewarding. It is also important to check in regularly with your doctor to ensure no activity is promoting muscle damage or resulting in adverse effects.

Intended outcomes
Regular exercise can improve flexibility, function, and sleep, better mood, and general health. Specifically for SMA, exercise may improve strength and motor function.1

Results
Few studies have researched the effects of exercise on SMA. However, these studies have hinted towards some modest improvements in strength and motor function.1

Constraints
Many people with SMA live with mobility, breathing, and strength issues that can make it challenging and discouraging to exercise.

Medication side effects can interfere with physical activity.

If you exercise too hard, you may feel sore for a day or two afterward. Soreness is a sign that you should take it a little easier next time. If one type of exercise does not work for you, consider trying another.

Inappropriate exercises may result in injury and increased risk of muscle atrophy.

Sources:
1. Resistance Strength Training Exercise in Children with Spinal Muscular Atrophy - Muscle & Nerve
2. Exercise may protect nerve cells in Spinal Muscular Atrophy patients - Science Daily
3. SMA and Exercise - SMA News Today

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